Abstract
Objectives: Patients with novel coronavirus disease 2019 (COVID-19) can present with gastrointestinal symptoms as their initial symptoms or as the main manifestations during disease progression, but the clinical characteristics of these patients are still unknown.Methods: We identified COVID-19 patients who admitted to Xiangyang No. 1 People's Hospital and presented with gastrointestinal symptoms as their initial or main symptoms. Their medical records were reviewed by two independent clinical scientists. The epidemiological and clinical characteristics as well as the clinical outcomes were analyzed.Results: Among 142 confirmed COVID-19 cases, 7 (4.9%) of them presented with gastrointestinal symptoms. Three patients had gastrointestinal symptoms as the initial symptoms and chief complaints, and 4 patients as the main symptoms during disease progression. Six patients had symptoms of diarrhea (3–16 days), 7 with anorexia (7–22 days), 6 with upper abdominal discomfort (1–7 days), and 4 with nausea (1–7 days), 1 with heartburn lasting 2 days, and 2 with vomiting symptoms (1 day). The chest CT scan showed typical COVID-19 imaging features, and associated with the progression of the disease. During treatment, 2 patients died due to organ failure.Discussion: COVID-19 patients with gastrointestinal symptoms are relatively rare and might be misdiagnosed. The clinical features include watery stools, anorexia, and upper abdominal discomfort. These patients may have severe disease and be associated with a poor prognosis. The underlying mechanisms of SARS-CoV-2 related gastrointestinal symptoms need to clarify in future studies.
Highlights
In December 2019, patients with pneumonia of unknown cause appeared in Wuhan, Hubei, China, and quickly spread to many provinces and even other countries in a short time [1]
Among the 142 COVID-19 cases, 7 patients were included in the study (P1–P7) after excluding patients with only anorexia and those with gastrointestinal symptoms lasting
Three patients had a history of travel to Wuhan, 2 patients had a history of close contact with Wuhan residents, and 1 patient’s family members were diagnosed with COVID-19
Summary
In December 2019, patients with pneumonia of unknown cause appeared in Wuhan, Hubei, China, and quickly spread to many provinces and even other countries in a short time [1]. It should be noted that COVID-19 cases with gastrointestinal symptoms may have a missed or delayed diagnosis, leading to unnecessary transmission of SARS-CoV-2 [11, 12] As of April 9, 2020, a total of 142 patients with COVID-19 were treated at Xiangyang No 1 People’s Hospital, China, of which 7 patients had gastrointestinal symptoms as their main clinical manifestations. This study summarized their epidemiological and clinical manifestations, as well as the associated clinical outcomes
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